Study Evaluating PK/PD and Safety of Betrixaban in Pediatric Patients

Inclusion Criteria:

1. Pediatric patients in the following age categories: 12 to < 18 years of age, 2 to < 12
years of age, and 28 days to < 2 years of age. Part 1 of the study will enroll only
adolescent patients 12 to < 18 years of age.

2. Patient is a pediatric subject requiring anticoagulant therapy, for example:

1. Has previous thrombosis and completed a course of anti-coagulant therapy, and is
considered to have a risk for recurrence of VTE, or

2. Has any stable disease with a risk for arterial or venous thrombotic disorder, or

3. Has any functional CVAD (Central Venous Access Device) in the upper or lower
venous system.

3. Patient has normalized coagulation parameters from recent anticoagulant therapy (INR
or PTT, as appropriate) within 7 days of study drug administration.

Exclusion Criteria:

Patients who meet any one of the following exclusion criteria will be excluded from the
study:

1. Patient received any dose of anti-coagulant therapy within 7 days of Day 1.

2. Patient has active bleeding or has a comorbid disorder that places the patient at high
risk for bleeding.

3. Patient has a comorbid disorder that places the patient at risk of death within 90
days of enrollment.

4. Patient has abnormal coagulation tests at baseline.

5. Patient has had recent or planned invasive procedures, including lumbar puncture and
removal of non-peripherally placed central lines during study.

6. Patient has hepatic disease associated with one or more of the following:

- Transaminase levels ≥ 2.5 × upper limit of normal (ULN) or bilirubin ≥ 1.5 × ULN
at baseline.

- Coagulopathy leading to a clinically relevant bleeding risk, or hepatic
transaminase level of > 2 × upper level of normal (ULN) or total bilirubin > 2 ×
ULN with direct bilirubin > 20% of the total.

- Platelet count < 75 × 109/L or hemoglobin < 10.0 mg/dL.

- Hypertension defined as > 95th percentile for age. Refer to Appendix A.

7. Patient has known congenital or acquired bleeding diathesis.

8. Patient requires concomitant therapy with a strong P-gp inhibitor.

9. Patient has previous history of any non-traumatic bleeding event that was life
threatening or required medical attention.

10. Patient had been administered thrombolytic therapy, or had undergone thrombectomy, or
insertion of a caval filter to treat prior VTE.

11. Patient has known inherited or acquired bleeding diathesis or coagulopathy.

12. Patient has abnormal QTcF interval on baseline ECG.

13. Patient will receive a dose of any antiplatelet medication (including aspirin) within
14 days before study drug dosing.

14. Patient has malabsorption disorders (e.g., cystic fibrosis or short bowel syndrome).

15. Patient has an estimated glomerular filtration rate (eGFR) < 30 mL/min.

16. Patient is unable or reluctant to cooperate with the study procedures.

17. Patient has hypersensitivity to other Factor Xa inhibitors, or the components of the
dosage form.

18. Patient has participated in a study with an investigational drug or medical device
within 30 days prior to administration of betrixaban.

19. Patient is female and is either pregnant or breastfeeding a child.

20. Patient is sexually active and is not using medically accepted contraceptive method
(if applicable).